半规管多平面重组技术及临床应用价值

目的：探讨半规管多平面重组的技术要点及临床应用价值。方法:对86例慢性化脓性中耳炎患者（正常79耳，病变93耳）行高分辨率CT（high resolution CT） 扫描, 正常耳比较轴位、重组冠状位及各半规管多平面重组（semicircular canal multi planar reconstruction， s MPR）图像整体显示半规管的形态和结构情况，比较3种图像对各半规管全程显示率，寻找显示各半规管全程的最佳方法；病变耳分别在轴位、重组冠状位及s MPR观察各半规管破坏情况，术中探查并详细记录各半规管破坏情况，并与术前CT图像比较。结果： 正常耳：轴位仅部分能显示外半规管全程，显示率为86.7％，上半规管、后半规管不能全程显示；重组冠状位各个半规管全程均不能完整显示；s MPR对各半规管全程在同一层面上显示率分别是：上半规管为92.45％，外半规管为100％，后半规管为97.58％；病变耳：8耳发生迷路瘘管，轴位、重组冠状位显示外半规管瘘分别为5耳和4耳、二者均显示上半规管瘘1耳；s MPR显示外半规管瘘6耳，上半规管瘘2耳。术中探查见外半规管瘘6耳，上半规管瘘2耳。结论：s MPR可完整显示各半规管全程，明确瘘管发生的具体位置，对迷路瘘管的诊断具有较高的价值。

Clinical value of semicircular canals multi-planar reconstruction by high resolution CT

Objective: To study the action of multiplanar reconstruction by high resolution CT(HRCT) in showing the full length of semicircular canal.Methods: HRCT was performed in 86 patients(79 normal ears and 93 ears with disease) with chronic otitis media(COM).The imagings of the full canal at axial,cranial and sMPR level were taken before treatment.Result: Of normal ears,86.7% of the full lateral semicircular canal could be shown at the axial level,and the superior and posterior semicircular canal could not be fully displayed;the lateral,superior and posterior semicircular canal could not be completely displayed at the cranial level;92.45% of the superior,all the lateral,97.58% of the posterior semicircular canal could be fully displayed at s-MPR level.Of the ears with disease,labyrinthine fistula of lateral semicircular canal was found in 5 ears at the axial and 4 ears at the cranial level;labyrinthine fistula of superior semicircular canal was found in 1 ears at both the axial and the cranial level;labyrinthine fistula of lateral and superior semicircular canal were respectively found in 6 and 2 ears at the s-MPR level,which corresponded with the operation findings.Conclusions: s-MPR can completely display the semicircular canal and definitely justify the position of labyrinthine fistula.